Sumayya P M
About Candidate
I am a CPC Certified Medical Coder with Over 2+ years of experience in Denial Management and Resubmission Processes. I hold a Bachelor’s degree in Biomedical Engineering.
Previously, I worked as a Denial Analyst at CCRCM, Burjeel Holdings, where I was responsible for analyzing and resolving insurance claim denials, reviewing payer requirements, preparing appeals, and ensuring compliance with healthcare regulations and insurance guidelines.
Throughout my professional experience, I have developed strong expertise in:
• Insurance claim processing and denial management.
• Claims resubmission and reconciliation activities.
• Medical coding compliance with DHA, HAAD, and payer guidelines.
• Root cause analysis of claim rejections and denials.
• Revenue cycle management and reimbursement optimization.
• Coordination with healthcare providers, coders, and insurance companies.
• Working with healthcare platforms such as Cerner, SAP, eClaim link, MyCare and BestCare.
• Maintaining accurate documentation and ensuring timely claim resolution.
